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Pain of aggravated preexisting condition not compensable

Posted On: Jul. 31, 2019 2:26 PM CST

Workers comp ruling

A worker’s repetitive injury claim that he said worsened a preexisting condition may not be compensable, the Supreme Court of North Dakota held Tuesday.

In State Ex Rel. Workforce Safety and Insurance v. Sandberg, the court reversed and remanded in a 6-0 decision an administrative law judge’s holding in favor of a worker with a preexisting degenerative disc condition.

John Sandberg spent his career working as a truck driver and heavy equipment operator and had been diagnosed with mild degenerative arthritis of the cervical spine. He also suffered from upper back and neck pain after a car accident in 2006, for which he sought care.

From 2002 to September 2015, Mr. Sandberg worked as a seasonal employee for Grand Forks, North Dakota-based Park Construction, operating a track hoe for railroad repairs. He said while operating the machine, he was routinely subjected to jarring, slipping and twisting while moving the track hoe over rocks and manipulating controls.

In 2003, he sought chiropractic care, and treatments stated that his issues stemmed from the track hoe at work. He received chiropractic treatment again for most of 2012 and half of 2015. On Sept. 28, 2015, he said he could no longer perform his job due to back pain and took an early seasonal layoff.

In July 2016, Mr. Sandberg filed a workers compensation claim for a cervical injury that occurred due to the repetitive movement and motion of operating the track hoe. North Dakota Workforce Safety & Insurance, a state fund, denied the claim and his request for reconsideration, determining that it was a preexisting condition of his degenerative disc disease. Mr. Sandberg requested an administrative hearing. An administrative law judge held that Mr. Sandberg’s work did not cause or substantially accelerate his condition; however, the judge found that his work substantially increased the severity of his pain and worsened his condition, and held that he met his burden of proving he sustained a compensable injury. A district court affirmed the decision and the WSI appealed, arguing that the administrative judge misapplied the law and contended that the “mere triggering of pain symptoms in a preexisting injury, disease, or other condition is not sufficient to establish a compensable injury” and the medical evidence in this case does not establish Sandberg sustained a compensable injury.

The Supreme Court of North Dakota agreed with the WSI and reversed and remanded the case. The court noted the administrative judge’s decision was based on the assertion that Mr. Sandberg’s work activities increased the severity of his pain, but noted that North Dakota statutes state that “pain may be considered in determining whether there is a substantial worsening of a preexisting injury, disease, or other condition but a compensable injury must be established by medical evidence supported by objective medical findings.” The court stated that the administrative judge failed to cite any medical evidence to support a determination that Mr. Sandberg’s repetitive work activities did not merely trigger symptoms, but rather substantially worsened the severity of his degenerative condition.

Neither attorney in the case responded to a request for comment.